AMPLIFIEDD VS AMPLE HX

AMPLIFIEDD (A MODIFIED VERSION OF THE “AMPLE HX”)

DESIGNED AND DEVELOPED FOR ORAL BOARD SIMULATIONS

© 1989-2019 Dwight Collman, MD DABEM, DABFM

This is a worst case scenario for the presenting history; the EXRs have the data you need.   You MUST ASK the questions or use your resources as listed below in the Q/A discussion  below.  Every type of simulation exists, i.e., those in which patients may die during the care is possible.  No history was available.  Simply do what you would normally do.  (Talk to the family and call for grief counseling).  Just because a patient died under your care does not mean you failed a case and the board would not want you to feel this stress during such an examination in general because most cannot function if they are told this during a live board certification examination.  So typically no one dies [meaning you ar not informed of that by EXRs…I think you know what I mean}….DDC.

A llergies:  

•  Unknown. 

M edications:  

• Unknown.   

P ast medical/surgical problems:  

PMH:  Unknown. 

Recent PMHx:  Unknown.        

ROS (ONLY THE CASE RELATED SYSTEMS REVIEW):  Unknown.

Social Hx:  Unknown.

• Past surgery:  Unknown.

ast meal:  

• Unknown. 

I mmediate events:   

• As indicated above.  

F amily, friends or family doctor:  

• Unable to contact parents (they were transported to another hospital). 

I mmunizations:  

• Unknown. 

E MTs or paramedics:  

• As indicated above.

D octor to admit/refer:  

• Dr. Trauma Surgeon and Dr. Burn Surgeon at the burn center.  [The patient will require transfer to the burn center]. 

D ocuments (old records):  

             • None available.

Here I will introduce you to my abbreviated version of writing called: “Density”  D4 is a very compressed form of the use of language.  I will use it as the web site develops over time and you get used to me  Years ago I read that once you reach a university level there is no need for proper spelling to transmit the same information.  Look at mathematics!  To most it looks like gibberish but it is just symbols to compress what would otherwise take up even more space.   I use D [DensityTM]  throughout my writing to decrease the amount of reading.  It should be obvious to most of you since this is not unlike what you do when you text each other.   

Q:  WHO ARE THE PROFESSIONALS YOU MIGHT INTERACT WITH OR RESOURCES YOU MIGHT USE IN CLINICAL PRACTICE…EXRS  MIGHT SAY THEY DON’T HAVE INFORMATION AS ABOVE…HOW CN U NAVIGATE THS [THIS] PROB?…THS IS REQUIR’D AS “PROBLEM SOLVING” = ⅛ F UR SCORE

A:  OLD RECORDS, IMMEDIATE FAMILY MEMBERS IN T ED, T PCC [POISON CONTROL CENTER], T PHARMACY, T PATIENT’S PILL BOTTLES, EVEN SENDING SOMEONE BACK TO T SCENE TO GET T PT’S MEDS IF NEEDED.  TREATING T PT EMPIRICALLY BASED ON SIGNS AND SXS MAY BE ALL YOU CAN DO…BT T KEY TO ALL AMS CASES IS IN T HX!   DONT JUST KEEP GIVING A DRUG IF A PT IS SZING!  DILANTIN IN OD CN CAUSE SZRS.  INH SZRS REQUIRE A SPECIFIC ANTIDOTE [PYRIDOXINE IN UP TO 5G DOSES Q 30 MIN].  

FINALLY, A MEDICAL ALERT TAG WHICH U FIND WHN U UNDRSS T PT [E IS FOR EXPOSE IN T PRIMARY SURVEY.  A REPEAT RAPID PRIMARY/SECONDARY SURVEY IS HOW YOU FIND A MISSED CA OR MISSED INJURY OR MISSD ILLNESS]…EXRs R ONLY ALLOWED TO ASK, “ANYTHING ELSE”  IF YOU SAY NO TO AN EXR 3 X’S & MISS’D SOMETHING THY GAVE YOU AMPLE OPPORTUNITY.  

THIS IS JUST LIKE A COURTROOM:  IF YOU ARE EXCUSED & NOT ASKED A “PATHO Q” BY YOUR “EXR JUDGE”  ITS BCAUS UR ACTNS PROV’D U KNEW T PATHO…ALL DEFENDANTS NOT ALLOWE TO DEFEND THEMSELVES IN COURT ARE RELEASED BCAUS T STATE [JUDGE] OR PROSECUTER] DECIDES THY HV NO CASE AGAINST THT DEFENDANT.  SO WHEN A JUDGE ORDERS A DEFENSE TO DECIST IT IS A GOOD THING…IT MEANS T DEFENDANT IS GOING TO BE RELEASED [THT IS BASED ON US LAW].  THS IS A SCORE RELATED TO YOUR CLINICAL ACUMEN/JUDGEMENT & KNOWLEDGE OF BOTH PATHO (PHYSICAL PRESENTATIONS [SXS AND SIGNS] AND LIFE THREATENING V SIGNS OR EVN COMPARISON W/A RECENT PRIOR EKG OR CXR.  ANY OF THS DATA MAY B AVAILABLE, BT U MST ASK FOR EACH ITEM!.

WE OFTEN DON’T REALIZE HOW MUCH INFO WE PROCESS IN A DAY…DDC.  

Published by DrC

Clinical Emergency Physician Faculty for Midwestern University EM Author/Educator/Medical Ilustrator Expertise: EM Pathophysiology and healthy physiology [both pediatric/adult] Designer of a silicone membrane ECMO Trained ⅓ of the world’s EPs for EM board certification Trained Oral Examiners for a decade: the Board of Certification in Emergency Medicine [5000 original members...now the second largest EM group in the United States]; he was a compensated consultant for that and numerous other emergency medicine organizations. All of his presentations have Co-sponsored AMA/ACEP category 1 CME ACCME accreditation through thecAAPS, National and The Fl Chapter of ACEP and The Fl Medical Association since 1989. Publisher of numerous EM manuals, and educational materials [all items were have copyrighted notices and have been sold sold by the ACEZp Bookstore]; all authored by Dr Collman: 2 Vol program syllabus of thousands of Q/As and pathophysiology discussions of all chapters from eds 3-8 of “The Study Guide” [All chapters of the core content knowledge for completion of an emergency medicine residency]; teachs Resususcitation, CV Emergencies, Pulmonary Emergencies, The EKG lab [the 60 most important EKGs/management; Truama Emergencies, Pain Mgmt, Orthopedic Emergencies, Toxicology [Toxins and Antidotes, HEENT Emergies, Environmental Emergencies, Pediatric Emergencies [500 Q/As], HIV/AIDs-Infectious Diseases, Emergencies, Rhematologic Emergencies, Neurologic Emergencies, Acid-Base/ABG Presentation, Dermatological Emergencies, CT/POCUS [point of care ultrasound], Bariatric Emergencies, Endocrine Emergencies. Dr Collman is endorse by virtual all of his programs participants [13,000+] Examples: Dr James SULLIVAN MD DABEM; and others program participants describe Dr Collman as a “National Treasure” Others: “He is the guru of EM”. [Jerry Solot DO, an EM Director for a Pittsburgh Community Hospital [and one of his private tutor clients] Others call me “The Boca University of Medicine”[BUM] and know I grandfathered into EM after completing a rotating Gen Surg Internship at UCLA School of Medicine [June 1981]. I was offered a directorship position at age 25, the contract to Illustrate “Emergency Management of Pediatric Trauma” [author:Thom Mayor MD FACEP] published by WB Saunders Dr Collman provides psychological support to his program attendees...many chose him to be their permanent career mentor and return annually to his live interactive conferences. Dr Collman has designed computer-based programming to numerous organizations in ACLS algorithms [Univ of Pisstburgh] He provides Interactive grand rounds as Case Simulations by invitation: He designed the an 8-h Visual Stimuli Presentation for Johns Hopkins Dept of EM [their board prep program;a second 8 hr presentation “The Genitourinary System-a Comprehensive 8-hour Review”; he teaches each program Johns Hopkins University. He trained Examiners for the BCEM [AAPS] Atlanta GA: presented a combined certification review [both certification part I/orals] numerous time in Atlanta, Hawaii, Lake Tahoe, and Orlando, Fl 1991-1996. He created their entire bard exam [part I and Oral Examination and a computer-operated Visual Examination [2 Versions] in 1996. This included 700 certification test items and 25 Oral Examination Live Test Simulations as well as trained their AAPS [BCEM Examiners twice a year for 10 years [throughout the 1990s] Texts Authored Editor in Chief 4th-7th Ed of: “Pearls of Wisdom in Emergency Medicine [7 eds] and 35 Cds [33 are critical analysis of the 52 OBT Live CD set: audio recording made Live at Conference [cost $1515.00 (Oral Board Case studies)+ ASA/APAP toxicology CDs [each is 1 hour w/manual purchase price $65.00 for each + “CT Video: CT for the Emergency Physician”. Videotaped Live in Boca Raton, FL by Pear Productions; director and producer: Clayton Pereira. Contributors: Kris, Katie, Ryan Collman Barbara Schwartz [voiceover] Original music: Kris Collman on Acoustic Guitar Chapter Voiceovers: Katie and Ryan Collman Katie and Ryan: Pediaric calculation presentation [at ages 6 and 4 they presented a 2 h lecture for 2 years at 6 conferences to every participant of “The 8-Day Interactive Review!” “Dwight Collman MD DABEM DABFM Provides the most rigorous CME Education”...documented by EM News and EMRA [in 2002 ranked Dr Collman’s EM 8-Day Interactive Review! with the top 8 University or top ACEP chapter programs [an independent study they published for all of America’s Emergency Medicine Residents preparing for their board certification examinations. 2009 Jan Issue EM News Editor-in-chief ranked Dr Collman as the “premier educator for board preparation in the US” Core Competencies: Bedside Clinical Instructor all EM Medicine Clinical assessment/training EPs in all EM Procedures [over 90 procedures] Core competency: illustrates human Anatomy as it pertains to EM/EM procedures [he does this Live and his clients request to keep his illustrations] Dr Collman edited Emergency Management of Pediatric Trauma [while he illustrated this First-Ever Text devoted to Pediatric Trauma; he spent 2 years creating the illustrations for this text [983-1985 and they were reproduced and resold bynthe publisher and appear in the Pediatric Trauma Capter of The Text: The Clinical Practice of Emergency Medicine” Ed 1., author Ann Lattimer-Harwood-Nuss [now Professor Emeritus, retired]. Completed a Fellowship in Gen Anesthesia: University of Utah School of Medicine Awarded 5 specialty rotations [mentor ship programs in medical school:ICU President: Collman Institute Inc [a Fl S-Corp] 1994-2007 and 2018 to present. Clinical practice x 40 Yrs ABEM certification Life Fellow Am Board of Forensic Examiners Trains EPs in triage/emergency Pt care/documentation to mitigate litigation risk Has been awarded contracts [per physician] from over 400 US Hospitals Trains EPs from every branch of the US Military since 1989 -first group I traine included the CO of the Portsmouth, Va Naval residency [Michael Gonzalez MD FACEP who officially made the Oral Board Tutorial! As mandatory education to graduate his residency program in 1989. I am a “trainer-educator, author, medical Illustrator” Additional self funded missionary physician to Ukraine, Carribean, S America since 1987...[ongoing] Supplied Orphanage in Kherson, Ukraine with new supplies $5,000. I have treated college students at no cost since the 1990s Additional skills/competencies: Documentation [chart review consultatnt], Test item Writer [wrote the entire certification partI/part II examinations in 1996 Teach/train using interactivity/I teach the statistical/mathematical precognitive approach to physicians for pediatric IV fluid protocols for resuscitation, 3 forms of dehydration, burn fluid calculations + formula for airway [pulmonary burns] 52 simulations in 5 days; the role of the CANs/EXRs; I have a program syllabus for both of my CME programs Program author/presenter: “The Clinical Documentation If the Emergency Medicine Hospital Chart”, a 2-Day program conducted in Park City, Utah [1992s] As a Forensic Examiner he has reviewed and consulted emergency Physician defendants [approx 300 cases over 25 years] He has presented to children at the local middle schools for Spanish River Christian School Three presentations: a “suturing practical in which young students sutured wounds created on Pigs feet’s, a Gastrointestinal presentation for the 4th grade; “what is an X-ray” lecture for the entire school; Dr Collman donated funds and participated in annual fundraising events at Spanish River School for 8myears]; he created background scenes for both Spanish River Christian School and recreated the Parthenon for a Greek Play for the second Grade at Westminster Academy in Ft Lauderdale. He greatest achievement is his role as a single father and he has watched his aforementioned adult children all have successful marriages: Kristopher David Collman will soon be an MD., JD; Katie is a school teacher since age 19 [retired after 11 years at Bethany Christian School as a primary school teacher 1st/3rd grade]; Katie has a successful site on Etsy and has been an annual missionary all 4 years of her undergraduate education to a Bolivian Orphanahe. She is a mother and married a minister. She has a son who she devotes her days but will likely return to education and she is an excellent artist and gifted/enjoys creating personalized crafts [her website on Etsy:”The Black Pearl” Ryan David Collman has completed a BA, 2 masters and now is again on his 4th fully funded Scolarship at Edinburgh University for his PHD in Christian Studies; he was able to and did Marry Kristopher to Amanda When Ryan was 22 year-old! He his also a self-trained painter and has been married to his wife Lauren who was the Salutatorian of their high School. All three have chosen service-oriented lives and qualify as the brilliant, talented and loyal loving spouse [both sons married brilliant accountants who are amazing mothers. Amanda is also a gifted artist. I call these three ladies “the sisters and they support each other no matter how far they live apart. Ryan and Lauren have e tensively travelled Western Europe with their daughter and currently since November they have a newborn son;his toddler sister attends school 3 days a week and reads her baby brother and sings. My eldest grandchild is in her 2nd grade year and she too has a younger baby brother and she is like her cousins happy, brilliant and all are healthy and thriving! They are my greatest joy! I don’t list their names because I want them to have their privacy/security. I did have to take a break from teaching to care for my parents who are both deceased as are two of my brothers; my mother was the owner/operator of Lil Audreys Health Spa USa and received a Lifetime Achievement Award from the State of Utah fir her work in keeping 40,000 women in Utah in shape/for helping thousands lose weight; many lost up to 100 lbs. Many were Lifetime members. My father, Joel Collman was an electrical/mechanical engineer by training, a brilliant man who became a designer for electrolysis on the first United States Nuclear Submarine then moved us from my birthplace [Huntington, NY] to Utah in 1959. Where he designed and built the rocket motors for our countries ICBMs [Miniteman I, II, and III series] and may have held as many as 90 patents; when he irked he then worked with mom as her accountant/collections Manager/he reengineered her Healthspa [a school they purchased]. my mother exercised and ate a healthy balanced diet was known by every woman in the State of Utah, often worked tirelessly for 12 h a day; never took a “sick day from medical illness.” I have 2 remaining siblings who live in Utah. I hope to one day reopen the “SPA” as a pvt medical facility for Antiaging and regenerative medicine while I continue all of my other above activities. Because of my mother I followed her advice to do everything in moderation, to protect my skin, and to sing as she did and to remember that your “true wealth is your health”. She lived by such rules and I would be nothing without her wisdom and love forvservice to others...I learned how to be a servant as a physician from my mother...I learned how to make rocket fuel from dad! I’m actively seeking new teaching opportunities and clinical practice as a faculty member or a clinical emergency physician while Incontinue to write and teach as many EPs andAPPs. I also hope to marry and have two more children.

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